For poor surrogates, a loaded bargain

In Kmounch village on the outskirts of Phnom Penh, at least six women have rented their wombs to foreigners over the past two years. There is little economic activity in the village itself, where women sit braiding each other’s hair, cooking over open fires or playing cards.

But each of the six surrogate mothers could receive up to $10,000 for her trouble – more than six and half times what a garment worker could make in a year on minimum wage.

In Cambodia, information about commercial surrogacy tends to spread by word of mouth, with women drawn to the industry through the recommendation of others. The first surrogate was recruited in the village almost two years ago, and gossip about payments for surrogate mothers spread like wildfire.

Now, the gossip is likely about how much longer such opportunities will exist in Cambodia. The government recently announced that it considers commercial surrogacy to be illegal, and is drafting legislation to ban the industry completely.

Australian Tammy Davis-Charles – the founder of agency Fertility Solutions PGD – and two Cambodian nationals were the first to suffer the legal consequences: Two weeks ago, they were arrested by Cambodia’s anti-trafficking police and charged for acting as an intermediary between adoptive parents and a pregnant woman.

There are at least 10 Western-run surrogacy agencies currently operating in Cambodia, according to Sam Everingham, the director of Australia-based organisation Families Through Surrogacy. He estimates they have facilitated more than 300 pregnancies to date.

At about $50,000 per pregnancy, that means the industry could be worth at least $15 million – and that’s excluding the work of the unknown number of Chinese-owned agencies and clinics operating in the Kingdom. There are 23 pregnant surrogates that have been recruited by Charles-Davis’s agency, meaning that her company alone could have collected at least $1 million.

Meanwhile, in Kmounch village, six women are trying to survive on the surrogacy “salary” they’ve earned.

AKmounch village, on the outskirts of Phnom Penh, is strewn with rubbish. Eliah Lillis

‘Doing whatever they can’
Taeary*, 33, lives down a narrow alleyway in the village. There is rubbish embedded in the mud outside of the door to her home. She was debt-ridden, desperate and preparing to sell it when she decided to become a surrogate. Her job cleaning construction sites didn’t bring in enough cash to cover her expenses, let alone her 2-year-old son’s medical bills.

So when her sister-in-law told her that she could make $10,000 by carrying a foreign couple’s baby, Taeary decided to do it. “In Cambodia, it’s impossible to pay off a $4,000 debt in one year,” Taeary says. “If I made $100 or $200 a month as a garment worker, then I would have to spend it all to support my family.”

The $10,000 she received for delivering a baby last year changed her life, she says. She was able to keep her home and pay for her son’s recovery. But the fact that no major disaster took place was a case of luck rather than a result of good practice, she says. During her pregnancy she was provided almost no support and little information. Everything she was given was in English.

Taeary didn’t know the name of the clinic she visited for the embryo transfer, and says she never signed a contract. “I asked for the name of the hospital where I would deliver the baby and they wouldn’t tell me . . . They just told me not to worry and said they wouldn’t hurt me,” she says.

Rodrigo Montero, a gender adviser for the German development agency GIZ, says such risks to women’s safety – and misinformation – are inherent to the industry. “The only measure which can effectively protect women from abuses of the surrogacy industry in countries where legal enforcement and health services are weak, like Cambodia, is to ban this industry,” Montero says.

“Unless Cambodian women have better economic opportunities, they will continue doing whatever they can to get the money they need, including renting their wombs.” Taeary’s clinic was somewhere near Phnom Penh’s Central Market, she says. After she delivered him through caesarean section, the baby boy was taken away so quickly that she never saw what he looked like. She was too exhausted to protest.

Limited information
In a one-room home nearby, Sophorn* sits on the floor, her pregnant belly bulging through the folds of her dress. The 32-year-old mother of four is spritely and effusive. Her young daughters dart in and out of the doorway.

Sophorn first learned about commercial surrogacy a little over a year ago, when she heard that a neighbour had earned $10,000 for carrying a foreigner’s child.

She contacted the woman, who agreed to be her broker for $50 a month. All Sophorn had to do was provide an ID, an address, and a statement claiming she was a widow. (Her husband is, in fact, alive.)

“I have four children and my father-in-law is handicapped,” Sophorn explains, her eyes welling up with tears. “It was for them I decided to try surrogacy.” With the help of her broker and a few doctors, everything was arranged inside the walls of the Phnom Penh-based Fertility Clinic of Cambodia (FCC), Sophorn says.

Hor Samnang, the FCC’s founder, maintains that claims of his clinic’s involvement in surrogacy are “false and misleading”. But during the first three months of her pregnancy, Sophorn says she rode her motorbike to the FCC for weekly checkups. Now that she’s five months pregnant, she goes to the clinic once a month.

“Every month, they’ll call me to remind me of my checkup,” says Sophorn, who is carrying a baby girl. In a plastic bag emblazoned with the FCC logo, Sophorn keeps the medications she was instructed to take throughout the pregnancy.

Among them are estrofem, an estrogen supplement, and utrogestan, a supplement for progesterone – each prescribed for women who undergo frozen embryo transplants to help prevent miscarriages and to support the embryo’s development.

Aside from the monthly checkup, Sophorn has little contact with the clinic or the agents who hired her. No one has come to check if she’s eating properly or if she’s smoking. The doctor told her to call the FCC if she fell ill. There were no further instructions.

But conversations with surrogacy agencies have revealed that they often promise prospective parents that they ensure that the surrogate mothers eat properly, don’t use drugs, and live in a healthy, clean environment.

According to Griffith University’s Patricia Fronek, who specialises in surrogacy and adoption, studies have demonstrated that foetal development is affected by poverty and stress. The medical procedures involved in surrogacy can also have long- and short-term impacts on the health of the mother and child, Fronek says.

Sophorn is thankful she hasn’t had a reason to call the clinic; her health throughout the pregnancy has been fine. But if something went wrong, she isn’t sure that there would be anyone to defend her. “I saw a lawyer working for the FCC and I asked if there were any legal protections for me,” Sophorn says. “But they told me they didn’t know.”

Sophorn stamped an English-language contract with her thumbprint. She says she didn’t know what the contract said. The only word she understood was “surrogacy”. “I really wanted the money, and I knew they would use a doctor, so I thought it would be okay,” she says.

It took eight months and three tries before an embryo took hold in her womb. She was given $50 to open a bank account, where her monthly stipend of $400 would be deposited.

Uncertainty and anxiety
Sophorn’s financial situation remains uncertain – she’s worried she won’t get her stipend this month. The woman who hired Sophorn was Tammy Davis-Charles, who now sits in Phnom Penh’s Prey Sar prison. Sophorn says she only met Davis-Charles once, when she was in the FCC for a checkup.

No one called Sophorn to explain the repercussions of the arrest, so she took it upon herself to call her broker after hearing the news. “She told me not to worry and that I’ll get my money,” Sophorn says.

But now that the legality of surrogacy is questionable, Sophorn says she’s at the mercy of the government. “I want to know if the government will help me,” she says. “I’m worried I won’t get my money if I deal with a broker.”

Last week, officials from the National Committee for Anti-Trafficking said agents and surrogate mothers operating in the Kingdom should continue to honour the commitments in their contracts. They did not, however, lay out plans to provide additional support for surrogate mothers.

Aside from the financial concerns, Sophorn says she’s constantly worried about the baby inside of her. “It feels like it’s our baby,” she says. “I love it, but I knew from the beginning that it’s not my child.”

When news broke of Tammy’s arrest, Sophorn’s neighbours suggested that she keep the child. If the baby were a boy, she says she might have considered it.

In countries like Thailand and India, cases of surrogate mothers wanting to keep the commissioned baby caused agents to promise prospective parents that surrogate mothers would pass psychological screenings before impregnation.

Sophorn, however, was offered no psychological support before or after she was selected as a surrogate. Knowing she’ll never learn the child’s fate after it’s taken overseas, she worries she’ll fall into depression. She became deeply depressed after losing her own 7-month-old baby boy to illness, she says.

Sophorn’s caesarean section is scheduled for April 9. She’s already delivered five children naturally, and is scared of having an operation. But this decision is also out of her control. Like Taeary, Sophorn has not been told where the surgery will take place.

“I think natural births are better, but what can I do?” she asks. “It’s a requirement that I have a caesarean.” After it’s over, Sophorn hopes to launch her own business as a food vendor and use the money to support her family.
“I don’t ever want to go back to working in a factory, because there’s no freedom,” says Sophorn.

“I won’t make a lot of money as a vendor,” she adds. “But at least we’ll have security, and I can take time off to care for my children.”

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